PREVENTIVE EFFECTS OF RECOMBINANT HUMAN EPIDERMAL GROWTH-FACTOR ON THE ESOPHAGEAL EPITHELIUM IN PIGS SUBJECTED TO SCLEROTHERAPY

Objective: To investigate the role of epidermal growth factor (ECF), a small (relative molecular mass 6000) polypeptide with mitogenic prope rties in the protection of gastrointestinal mucosal integrity. Design: A prospective, randomized and blinded study. Methods: Twenty-four min ipigs with surgically induced portal hypertension underwent four conse cutive weekly sessions of oesophageal sclerotherapy with 5 ml 1% polid ocanol and were concomitantly treated with either a placebo or human r ecombinant ECF administered subcutaneously Mucosal damage was evaluate d on a weekly basis by endoscopic estimation of the size of the ulcera ted area and by post-mortem morphometry. The EGF-induced morphological changes in the oesophageal epithelium were also evaluated histologica lly. Results: in sclerosed and non-sclerosed parts of the oesophagus E CF significantly increased the thickness of the oesophageal epithelium (P<0.03), but failed to reduce significantly the degree of oesophagea l damage associated with sclerotherapy (P = 0.11). Conclusions: System ic EGF treatment induces proliferation of the oesophageal mucosa, and EGF may therefore have the potential to reduce sclerotherapy-induced o esophageal damage.